1. Gregorio C. Rulloda
Vice-President and Spokesperson
Corporate Affairs Group
PhilHealth :
Achieving Universal
Health Care for All
Filipinos
2. Strategic Thrusts - UHC
2. Improved access to quality
hospitals and health care facilities
1. Financial risk protection by
expanding NHIP enrollment
and benefit delivery
3. Strategic Thrusts - UHC
3. Attainment of the health-related MDGs:
reduction of maternal and child mortality,
morbidity and mortality from TB and malaria
and the prevalence of HIV/AIDS
3. Preparedness from emerging
disease trends
4. Prevention and control of non-
communicable diseases
4. PhilHealth’s ROLE & GOAL
Vision
Bawat Pilipino Miyembro
Bawat Myembro Protektado
Kalusugan Natin Segurado
Mission
"Sulit na Benepisyo sa Bawat Miyembro,
Dekalidad na Serbisyo para sa Lahat"
5. Specific Goals
• Willingness to pay a fair premium
Payor’s appreciation of
Philhealth’s value
• Universal coverage for basic healthcare needs
Enrolment of entire
population
• Transparent provision of needed goods and
services to all members at set PhilHealth rates
Providers’ enthusiasm
to partner with
PhilHealth
• PhilHealth contributes to all medical
transactions
Patients’ utilization of
benefits and packages
• Trust in the institution for partnership and
employment opportunities
Enhanced Reputation
as a center of
governance excellence
6. Bawat Pilipino, Miyembro
Employees
OFWs
Individually
Paying Members
Lifetime Members
Sponsored Members
SOCIAL SOLIDARITY: Bayanihan into the National Health Insurance
Program where the healthy, wealthy and unaffected look after the
sick, poor and afflicted.
No one is excluded, everybody are entitled to the care of the nation. All
are members and all have rights & responsibilities, and being a contributing
member alone allows everybody to fulfill their responsibilities.
7. Children who
are below 21
years old
Spouse of the member
Parents who
are 60 years
old & above
who are not
members
Who are the qualified dependents…?
Bawat Pilipino, Miyembro
8. Bawat Pilipino, Miyembro
85%
“Sa kalusugan naman po: Nang
dumating tayo, animnapu’t
dalawang porsiyento lamang ng
mga Pilipino ang naka-enrol sa
PhilHealth. …..Ngayon po, 85
percent ng lahat ng mamamayan,
miyembro na nito. Ang ibig pong
sabihin, 23.31 million na Pilipino
ang naidagdag sa mga saklaw ng
PhilHealth mula nang bigyan tayo
ng mandato. “
9. Sector
Registered
Members
Dependents
Members
and
Dependents
Employed 11.36 13.69 25.05
Government 2.03 4.00 6.03
Private 9.33 9.69 19.02
Sponsored Members 10.06 29.83 39.89
Individually-Paying 4.74 6.07 10.81
Lifetime Members 0.61 0.42 1.03
Overseas Workers 2.63 2.55 5.18
Total 29.40 52.56 81.96
Bawat Pilipino, Miyembro
13. Bawat Pilipino, Miyembro
Bringing information closer to Members and
Empowering Members
PhilHealth Taps Social Media for SHI Advocacy
www.facebook.com/philhealth
teamphilhealth
email.actioncenter@philhealth.gov.ph
From: carina_mana@yahoo.com.ph
Sent: Thursday, June 07, 2012, 3:27 PM
To: actioncenter@philhealth.gov.ph
Subject: PHILHEALTH number verification
Hi,
This is so great, I hope PAGIBIG service will follow your footsteps
in serving their people. Anyways, I will continue with my
contributions starting this month and again thank you very much
for your immediate assistance on this matter
Cheeers!
16. Bawat Pilipino, Miyembro
Bringing information closer to Members
and Empowering members
PhilHealth SHInES at House of
Representatives
PhilHealth Launched SHInES in Iloilo City
17. Bawat Pilipino, Miyembro
Bringing information closer to
Members, Empowering them
PhilHealth Expo Launches the
"Be PhilHealth Now" Campaign
18. Bawat Pilipino, Miyembro
Bringing information closer to Members
and Empowering Members
PhilHeath's e-Innovations for
Health Launched
Enables individuals to register
online
Enables employers to
post payments of their
employees on real time
Registration, billing and query of
Organized Groups
Electronic Payment Facilities
Remittance-By-Air thru text
19. Bawat Pilipino, Miyembro
PhilHeath's e-Innovations for
Health Launched
Facility for viewing the locations of health
facilities and visualization of various
corporate data using maps
Facility for checking membership status of
Sponsored Members under the NHTS-PR
during benefits availment
Facility for checking
eligibility of membership
and filing of claims by
HCPs
Bringing information closer to Members
and Empowering Members
20. Bawat Pilipino, Miyembro
PhilHeath’s presence and visibility
in various fora, conventions,
special events and similar
activities
Bringing information closer to Members
and empowering Members
2012 Kabisig National
Government Expo
2nd Philippine
Print Media
Congress
Umagang Kay Ganda
Kapamilya Services
DZMM’s "Takbo para sa
Karunungan"
Region 6 Inter Agency
Tournament
Iloilo Charter Day
21. PhilHealth’s Deliverable to the Society: Financial Risk
Protection
Every Filipino can get financial assistance, have
access to excellent providers where health care is
paid for, use the assistance when needed, and
receive significant support
• Bawat Miyembro, Protektado
22. Bawat Miyembro, Protektado
To have the opportunity to get
financial assistance whenever it
might be needed
ANG PREMIUM AY ABOT
KAYA!!!
Sa halagang P3.33 /day or
P100.00/month o depende
sa buwanang kita para
sa mga empleyado at
professionals
23. Bawat Miyembro, Protektado
To have accessibility to health professionals
and facilities where quality health care is
paid for;
24. Bawat Miyembro, Protektado
To actually use
the assistance
when needed
when doing so, to
receive a
significant
amount of support
54%
13%
13%
9%
11% Outof Pocket
National
Local
SocialHealth Insurance
Others
28. Bawat Miyembro, Protektado
PhilHeath's e-Innovations for
Health Launched
Facility for viewing the locations of health
facilities and visualization of various
corporate data using maps
Facility for checking membership status of
Sponsored Members under the NHTS-PR
during benefits availment
Facility for checking
eligibility of membership
and filing of claims by
HCPs
Easy access to members and stakeholders
in benefit availment
29. Kalusugan Natin, Segurado
No Filipino will ever be financially afraid of
getting sick, and that no one will left behind
in the race toward universal health care and
financial risk protection
PhilHealth needs to and will leverage its
purchasing power to help break the silos
and foster increased collaboration
Adress inequities in Health
30. Kalusugan Natin, Segurado
How to use PhilHealth’s purchasing power?
Use Performance Commitment
Contracts to ensure that health
facilities are safe and high
quality;
Provide incentives to ensure that
health human resource is
adequate in number, purposely
distributed and properly
compensated
31. Kalusugan Natin, Segurado
How to use its purchasing power?
Negotiate for lower costs and charges of health
care goods and services
32. Kalusugan Natin, Segurado
PhilHealth want to change HOW health care
services are rendered by providers with care
and received by members with pride
Case payment for all diseases – provides clear,
explicit and predictable financial support;
Case Rates - Since
September 1, 2011,
there were 11 medical
cases and 12 surgical
procedures being paid
through case rate
33. Kalusugan Natin, Segurado
“…Ito po ang proseso ng
pagpapagamot para sa kanila:
Papasok ka sa alinmang
ospital ng gobyerno. Ipapakita
mo ang iyong PhilHealth card.
Magpapagamot ka. At uuwi
kang maginhawa nang walang
inilabas ni isang kusing…”
No Balance Billing Policy (SAPAT NA ANG BAYAD NG
PHILHEALTH)
Protection from financial impacts of health care use by improving benefit delivery ratio of the NHIP Upgrading of government-owned and operated hospitals and health facilities.
Improving health is central to the Millennium Development Goals (MDG)
The new corporate website, www.philhealth.gov.ph , which promises to be more user-friendly but is still packed with the necessary information on the National Health Insurance Program that a PhilHealth stakeholder needs. The new website opens to three major sections, namely, MEMBERS, CORPORATE PARTNERS and ONLINE SERVICES. The MEMBERS section leads site visitors to the five (5) member-categories, while the CORPORATE PARTNERS section leads to our accredited facilities, health care professionals, collecting agents, as well as to private partners. Finally, the ONLINE SERVICES features several electronic facilities that include the eRegistration, eClaims, and PhilGIS.
Pending the complete payment mechanism of case payment for all types of illness, Philhealth will still continue the fee for service payment. Fee for service reimbursements is the kind of health insurance policy wherein payment to health care providers is made at the time of service. The benefits are subject to some limits which differ based on the level of the health care facility (Level 1, 2, 3, 4) and the severity of the cause of admission (Case type A, B, C, D)